“Physicians never should underestimate their importance when acting as advocates for children. The physician who is willing to act on behalf of a child suspected of being abused or neglected is one of the most important advocates a child can have”. —The Editor
Health care providers are often the first point of call for distressed parents and caregivers. This makes it a prerequisite that health care providers have the knowledge and skills to identify sexual abuse and provide an empathetic and supportive response to children when they disclose or show signs of abuse. Health care providers can also help to connect survivors of abuse to other services that they may need through referrals. However, health care providers can also play a key role in the prevention of Child Sexual Abuse :
- By training themselves on Child Sexual Abuse, Child maltreatment and being aware of the lifelong impact of maltreatment on psychological, physical, and emotional health.
- By providing tailored education and anticipatory guidance to the child and his or her caregiver.
- Talking to children and their caregivers about what behaviour from an adult or peer is appropriate and safe and how to respond to any unsafe situation/touch.
- Studies have shown that busy physicians may be able to spend as little as one-minute discussing anticipatory guidance with parents. One proposed strategy for addressing this hurdle is to provide group parenting classes to discuss such issues.
- As paediatricians have contact with families during challenging and stressful times (e.g., when a child is ill), they can become familiar with a family’s stressors and strengths. Paediatricians can play a role in preventing child maltreatment if they understand the situations that commonly trigger maltreatment.
- Assessing children’s level of risk for sexual abuse through regular assessment of Child-Parent Environment, Emotional/behavioural difficulties, chronic illness, physical disabilities, and low self-esteem, family or intimate partner violence (APPI guideline)
- By using communication methods that are appropriate to the patient group and listening to children and young people and considering their views when making decisions will help the child and family perceive the physician as a trusted adult.
- By helping caregivers to differentiate normal sexual behaviour from behaviour that is more concerning is helpful. In toddlers, for example, a parent may be concerned that their child occasionally tries to view them while they are in the shower. This would be classified as normal behaviour for a child of this age. The physician could conduct a thorough history of this behaviour, and use clinical reasoning to rule out any more concerning signs or symptoms.
How can Arpan Help?
The physicians concerned with the welfare of children and advocates for the prevention of CSA need to work with other systemic bodies and local communities to usher meaningful change. In order to build linkages with health professionals, Arpan conducts 3-5 days training for professionals to build capacities to engage on issues of child protection.